单半球双部位阳极经颅直流电刺激对中风患者脑代谢变化的影响:一项随机临床试验。

The Effect of Uni-Hemispheric Dual-Site Anodal tDCS on Brain Metabolic Changes in Stroke Patients: A Randomized Clinical Trial.

作者信息

Azarnia Somaye, Ezzati Kamran, Saberi Alia, Naghdi Soofia, Abdollahi Iraj, Jaberzadeh Shapour

机构信息

Department of Physiotherapy, Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13834, Iran.

Neuroscience Research Centre, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht 41937-13111, Iran.

出版信息

Brain Sci. 2023 Jul 20;13(7):1100. doi: 10.3390/brainsci13071100.

Abstract

Uni-hemispheric concurrent dual-site anodal transcranial direct current stimulation (UHCDS a-tDCS) of the primary motor cortex (M) and the dorsolateral prefrontal cortex (DLPFC) may enhance the efficacy of a-tDCS after stroke. However, the cellular and molecular mechanisms underlying its beneficial effects have not been defined. We aimed to investigate the effect of a-tDCS on brain metabolite concentrations (N-acetyl aspartate (NAA), choline (Cho)) in stroke patients using magnetic resonance spectroscopy (MRS). In this double-blind, sham-controlled, randomized clinical trial (RCT), 18 patients with a first chronic stroke in the territory of the middle cerebral artery trunk were recruited. Patients were allocated to one of the following two groups: (1) Experimental 1, who received five consecutive sessions of a-tDCS M (active)-DLPFC (active). (2) Experimental 2, who received five consecutive sessions of a-tDCS M1 (active)-DLPFC (sham). MRS assessments were performed before and 24 h after the last intervention. Results showed that after five sessions of a-tDCS there were no significant changes in NAA and Cho levels between groups (Cohen's d = 1.4, Cohen's d = 0.93). Thus, dual site a-tDCS did not affect brain metabolites compared to single site a-tDCS M.

摘要

对初级运动皮层(M)和背外侧前额叶皮层(DLPFC)进行单半球同步双部位阳极经颅直流电刺激(UHCDS a-tDCS)可能会提高中风后a-tDCS的疗效。然而,其有益效果背后的细胞和分子机制尚未明确。我们旨在使用磁共振波谱(MRS)研究a-tDCS对中风患者脑代谢物浓度(N-乙酰天门冬氨酸(NAA)、胆碱(Cho))的影响。在这项双盲、假刺激对照、随机临床试验(RCT)中,招募了18名首次发生大脑中动脉主干区域慢性中风的患者。患者被分配到以下两组之一:(1)实验组1,接受连续五节a-tDCS M(有效)-DLPFC(有效)治疗。(2)实验组2,接受连续五节a-tDCS M1(有效)-DLPFC(假刺激)治疗。在最后一次干预前和干预后24小时进行MRS评估。结果显示,五节a-tDCS治疗后,两组之间的NAA和Cho水平无显著变化(科恩d值=1.4,科恩d值=0.93)。因此,与单部位a-tDCS M相比,双部位a-tDCS不影响脑代谢物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2219/10377241/c84528a847ce/brainsci-13-01100-g001.jpg

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